Q. The generic form of Xanax, alprazolam, does not work for me. It is at best 50 percent effective.
A few years ago I was given alprazolam in place of Xanax. My panic attacks came back with a vengeance. I kept thinking I had missed a dose. After three refills over three months and a visit to my doctor, I asked him if other people had complained. He said yes and wrote the prescription for Xanax only. It made a noticeable difference.
My insurance company recently stopped allowing this and now I can only afford alprazolam. My anxiety is back. What’s going on?

A. Whenever a benzodiazepine drug like alprazolam, clonazepam, diazepam or lorazepam is stopped suddenly the patient can experience withdrawal symptoms. These include anxiety, panic, insomnia, muscle spasms, shock-like sensations, dizziness and headache.
It seems as though you may have had a withdrawal reaction when you switched to the generic alprazolam. That suggests that the generic is not truly equivalent for you. Perhaps your doctor can intervene with the insurance company on your behalf.

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  1. Shirley

    I have not been on Xanax. However, I do have an intolerance to salicylates and those chemicals with similar chemical structure. The generic of some pills have a non-active ingredient that causes problems. Insurance companies need to listen to their customers and make adjustments when needed.

  2. Donna

    I took 1 mg. (brand) of Xanax XR everyday for ten years. My health insurance changed and I had to switch to a generic. I tried Greenstone and became very ill shortly after switching. I called several times to seek help. You are on a recorded line and the workers are reading from a script. I am retired and can’t afford the Brand – I want my life back but don’t know what to do. I am a social worker and have talked with psychiatrists in the field and have been told that many of the generics do not work. I also found out that some of the cancer medications that save lives cost $380 a pill and many people who are in need, can’t afford to purchase them. I also learned that the pharmaceutical companies are out to make a profit not help us live a better live. How sad!!!!

  3. Jeremy
    south florida

    I’ve been taking benzos for anxiety disorder for around 8 years. it started with klonopin, which was an effective drug but slowly my condition worsened and I ended up in the hospital and was put on valium 10mg, also an effective drug but I built a tolerance to it very quickly and my doctor prescribed xanax 2mg x 4 daily.

    I started out with greenstone from cvs and it was working fine and for around 3 years I was doing fine and managing my anxiety. After started getting my script as purepac, there was an immediate problem and my symptoms were not being helped by the generic purepac… crawling skin, sweating, anger and a lot of other issues.

    I decided to switch back but none of the drugstores in my area constantly even had the drug in stock.

    Now I drive 25 miles every month to get the greenstone brand, they are always in stock and my anxiety is back under control. There is a difference in these medications, I am very sensitive to these kind of things and I am certain that it isn’t just in my mind. I will only take greenstone generic… purepac is pure junk in my opinion. It may cost a little less but it’s not worth saving the money to go thru panic attack hell. Greenstone is the best.

    • mary

      Do they taste bitter? s 90 3? thx

  4. Rex

    Xanax – Good All others – Bad

  5. Rondo
    Jacksonville, FL

    After reading these posts I know what most of you are going through. I’ve been taking Alprazolam 1mg twice daily for anxiety for over 10 years. It’s a blessing, truly. No amount of “counseling” or therapy (talking it out, BS!) can do what a little bit of medication can. I take a half pill (.50mg) when I awake, then when I feel myself tensing up or my mind begins racing and/or I began OCD’ing over minor stuff throughout the day and it does the job splendidly. However, like others I recently switched my prescription to Sam’s Club (Walmart) due to price concerns. Big mistake. Sam’s Club is currently obtaining this medicine from Qualitest, an Endo company. They have had quality control issues in the past, though that is no indication that this is a concern at this time, just saying. The CVS pharmacy I had been obtaining my medication from informed me that there supplier was Sandoz. A bit of internet research shows that this company did not have near as many negative reviews as Qualitest; though I do realize that personal reviews are anecdotal. My personal experience is that I do not like Qualitest and will return to CVS, damn the price increase, and get a better quality product. I have no desire to go “Pulp Fiction” on a pharmacy for lack of quality meds.

    • Deb
      San Diego, CA

      I have been on Sandoz Alprazolam for years, and (like you) it works like a charm for me when I need it, with no side effects. I am on a short hiatus to the east coast and went to the local CVS Pharmacy to refill my meds (I use CVS back in California, too). I was given Qualitest instead of Sandoz but I didn’t think it would matter. I took one pill earlier today (0.5mg) when I was feeling especially jittery and panicky, and within 15 minutes I became so drowsy that I literally couldn’t keep my eyes open. It does ease my mind to some extent but it’s not consistent enough for me to be able to trust it. Plus, it doesn’t do a very good job of removing my physical symptoms (finger and spine tingling, etc.).

      I am floored that this brand is so vastly different than my good old Sandoz!

  6. Jcle

    If you can’t find Greenstone, my second choice would be Mylan. If for some reason you can’t get Mylan, then get Purepac. Stay away from Sandoz and Sun Pharmaceuticals.

  7. Jcle
    United States

    Greenstone Brand Xanax (alpraxolam) which is generic is the closest thing to the name brand. Greenstone is owned by Pfizer, which makes the name brand. I could never tell a difference between name brand and Greenstone brand.

  8. Lillie R.

    The xanax I am taking now is just like a sugar pill. It doesn’t help the anxiety, or the panic attacks and it makes me feel worse at times. The drug store is always changing where the next generic. I and people like me need is the real thing and make it affordable. The ones I have gives me eyes pains so bad, I can hardly stand it. Is it something we can do to protect ourself? Panic attacks are hard to live with. The only generic brand I can deal with is greenstone, but the drug store changed places and I am a basket case, thanks for letting me write this.

  9. paul43

    Try changing to ClonazePAM— works great for me

  10. Eddie

    So glad I stumbled on this site. I too have trouble with generic Xanax. Have been paying out of the nose for brand. One generic gave me such rebound anxiety when it wore off, and only lasted about an hour. I appreciate all the comments. Thanks

  11. Charles W.

    Thank you so much for this detailed information on generic Xanax. Thanks to all that submitted detailed information out of the goodness of their hearts to help others dealing with the same prescription issue. It makes my prescription choice so much easier and saves me a lot of grief over figuring out why the generic Xanax did not work and what I will get prescribed next time.

  12. LKD

    My costco has greenstone~!!!! omg I searched forever costco rocks~!

    • Lyman

      Now my Costco has switched to Sandoz brand :-(

  13. RSP

    I have an incredibly sensitive nervous system. So I speak with credibility.
    I started taking Xanax (.5 mg.) when the drug was NOT available as a generic, back in 1987. When Xanax came out as a generic, and I started taking the generic version. I informed my doctor that the generic just doesn’t work as well as the name brand. The physician is a psychiatrist and has a lot of experience with patients on this drug.
    Instead of giving me the usual “speech” you get from a pharmacist about “The generic has the same amount of ingredients as the name brand,” my physician actually acknowledged my statement and added, “Many of my patients have been saying the same thing!” He switched me back to the name brand.
    Unfortunately, I’m retired now, on a fixed income, and the name brand is very very cost prohibitive. Consequently, I’m at a loss trying to figure out if it is worth the extra cost to go back to the name brand.
    I’ve had little if no efficacy from generic brands like Mylan, and Purepac.
    I go to CVS and REQUEST Greenstone. I’ve only recently had one ineffective batch from Greenstone. Previous Greenstone prescriptions have been satisfactory.
    All Greenstone will do for me is offer me a refund, with an apology letter. By phone they stated they wanted to know the “batch number” would send me out an envelope to mail back a sample for lab analysis, and will give CVS a credit so they can substitute another batch number as a replacement prescription. It’s all an act on their part. It’s been 6 weeks and after 3 contacts (2 by phone and 1 by mail. Unfortunately, we’re all just little inconsequential little people.
    CVS will generally order a particular brand for you, but you must request it from the pharmacist (not the pharmacist’s technician.)
    I’ve called upon 4 Walgreens stores. Three will not do a “special order” for your requested brand of generic, and pharmacist said he would. I was told by staff, “it depends on the manager of that particular store.”

  14. LKD

    Now even Greenstone is hard to find in 1Mg tabs so my Doc wrote script for half the amount in 2Mg logs. Some pharmacies carry the 2’s but not less. I told Publix if they don’t carry Greenstone I have to take my business elsewhere. They don’t care, so I did~!

  15. Rojas

    Well, I can attest to the fact that generic doesn’t work as well. I only take Xanax for flying. My last flight I took the Alprazolam and I ended up getting off the plane before take off. I felt so defeated. Normally, I can take the Xanax just as I’m getting on the plane and within seconds all is right with the world. This time I took 1 Alprazolam and I got that initial feeling of the relaxing of the muscles but the anxiety didn’t go away. So I took another one. Still didn’t go away. The pills are .5 mg!
    An hour later after my daughter picked me up from the airport and I was home, I was still feeling anxious. It was as if the pills made it worse. So I’m not taking that again. And yes, it was from CVS so I learned something by reading all the other posts. Thanks guys!

  16. P. Dick

    Wow, I didn’t realize how much of xanax was placebo.

    • CARON
      owings mills, md 21117

      I agree with you.

  17. LKD

    Confirming that others have also seen Greenstone as the best GENERIC XANAX brand. I have two brands and can attest to the difference. I also hear that CVS change suppliers depending on the price they get at the time so ALWAYS INSIST ON GREENSTONE Alprazolam the generic pharmaceutical subsidiary of Pfizer Inc., OR, GWAD KNOWS WHAT YOU ARE GETTING.

  18. Kathy

    I recently switched pharmacies for my generic Xanax. After this bottle I’m switching back. The manufacturer of the generic Xanax 0.50 from Walgreens doesn’t work for me. It dissolves so fast that I end up swallowing most of it. That’s why it is not as effective. And I just started a new job! Bad timing. My anxiety is out of control and and I am hating life.

  19. LKD

    Greenstone LLC, is now the generic pharmaceutical subsidiary of Pfizer Inc.
    Xanax brand is from Pharmacia & Upjohn Co.
    Here in Tampa most if not all of the Eckherd Drug Stores have been bought by CVS.
    I called CVS locally and they tell me they carry the Greenstone brand, Alprazolam.
    My insurance no longer covers Xanax and I am forced to go generic.
    The price is 10 times higher for the brand name.
    I take 1Mg pills and they are about 27.00 for 90 and the brand names are about 270.00
    I too feel that the generics are just not as potent or is it because I have been on them for so long.
    About 6 years since a head injury causes insomnia. Now I need two to have a good nights sleep.
    Even if shopping at CVS its a good idea to ask who made the Alprazolam so you will know.
    Many druggists will order the brand you ask for.

  20. JNA

    I have problems with certain manufacturers of generic Xanax also. I take a VERY VERY low dose of Xanax as needed for anxiety, to give you an example of how little I use it, it took me over a year to use 60 .25mg tabs, and that’s including the fact that I have to share with my cat sometimes (the vet told me to give her .125-.25mg for the long car rides between home and college, she offered to give me a prescription for the cat, but I figured why bother when I take the exact same dose).
    I had always done fine with anywhere from .125-.5mg depending on the severity; most of the time I would take between .125-.25mg for my occasional small anxiety attacks, .375mg for my occasional-rare medium anxiety attacks, and .5mg for the very VERY rare intense anxiety attack. The frequency of my attacks tends to cycle somewhat, I think it correlates to either a manic, hypomanic, or mixed episode of my bipolar, which is controlled for the most part, but I still have the occasional episode. I’m generally pretty good about knowing how much I need to take, to take the edge off of the anxiety, it’s all dependent on the level of my anxiety. If I took .5 on a day where I was having a very mild anxiety attack, I would be sleepy and feel drugged. However, if I was pretty much having a panic attack and took .5 it would take the edge off and allow me to relax long enough to try and get my anxiety under control using some CBT techniques I have been taught.
    Well, I was in one of those cycles where my anxiety was bothering me a fair amount. So, I took .25 figuring that should take care of it. After an hour, I felt no improvement, Xanax is supposed to be a fast acting medication, I normally notice significant improvement after 20 mins, 30 mins max. This time, nothing after an hour, so I took .125 more, hour later, still no change so I took .125 more, I now had a total of .5mg in my body and was not really getting any relief. I tried my therapy stuff, but it just wasn’t cutting it, so I broke down and took .25 more because I was at my wit’s end, for a grand total of .75mg….that was the dose that finally cut if for a mild to maybe medium level anxiety attack. I’ve taken .75mg or higher like a total of 3 times in my life and each time it was because my anxiety had gone through the roof and around the block due to being already in a state of anxiety from just whatever when I was confronted with an extreme triggering event.
    Anyways, I thought it was weird that I had to take that much, but I just thought that maybe my anxiety was worse than I thought it had been. However, a few days later when I had another mild attack, I ended up having to take .5mg. After a few more episodes of just feeling like my usual previous dose wasn’t cutting it, I mentioned the problem to my mom who is an ARNP.
    She casually asked me if the pills in this bottle looked any different than the previous bottles. I then realized that yeah, the pill was different, it didn’t even split nicely, it crumbled slightly, when it’s meant to be scored for easy splitting. Well, she called our pharmacy to find out if they had changed their manufacturer recently. They said yes. So when my mom told me this, I began to do some research online into the different generic manufacturers of Xanax.
    I found that most people reported very high levels of success with Greenstone, and said that the one my pharmacy had just switched to was horrible. I looked into Greenstone a little more and realized why people reported absolutely no difference between it and the brand, Greenstone is a subsidiary company of Pfizer, the brand manufacturer of Xanax, it is what I think they call an authorized generic. My guess would be that Greenstone has the exact same composition as the brand, or is closer than any other company would be able to get.
    So, I found a pharmacy that carried Greenstone. That was the 60 tab bottle that I had that lasted for over a year. Now, the pharmacy I got it from has stopped carrying Greenstone. I’m back to the search for a pharmacy that carries this elusive generic, or see how much the brand would cost with my insurance.
    Some people may say that I should just get the cheaper generic and take a higher dose, but my mother and my PCP said that although I need more for it to be effective, we can’t know for sure that I won’t experience any withdrawals or other negative side effects from taking over .5mg for mild anxiety attacks that used to be cured by .125mg, and considering sometimes when I’m in a manic episode, I’ll have a week where I need that low dose of normally .125mg 3-4 nights in a row and can stop after the 4th night when I no longer need it with no withdrawal symptoms, but .5mg 3-4 nights in a row could cause withdrawals if I didn’t taper the med. Therefore, I would need more medication more often, something I don’t want.
    I already get looked at funny by the PA’s at the school health center and any specialist I go see, when I tell them I take Xanax, even after I tell them that it took me 15 mo to go through ~50 .25mg tabs (60 minus the ~10 I shared with the cat), they look at me like I’m an addict or I must have drug seeking tendencies.

  21. Nancy J N

    A couple points here. Drugs for panic attacks only LESSEN occurrences! Get some sort of counseling for true relief. I’m not going to tell you that it is easy. Taking a pill is easier. But for all the years I’ve been in and out of counseling, I’ve become overall more comfortable with myself and situations. I actually was able to realize I was having an anxiety attack (I’ve also had panic attacks) but I was able to say ‘Whoa!’ Much better.
    ANY MENTAL disease is both biochemical AND environmental. Drugs do the first, counseling helps the second. Get them both somehow. Find a counselor you can afford and you are comfortable with.
    Number two: Generics are proven to be equivalent to name brand drug if the parameters of the drug, absorption, maximum concentration and elimination are with — 80% — of the original. I used to do this kind of work (Great Boss! and, I will add, a very devout and kind Muslim). So perhaps you need 20% more of this drug. Some generics really don’t work as well for some people, under certain conditions or by the whims of fate. The insurance companies have us by the short hairs by refusing to let us even have the brand name. Look around for alternatives, if possible. The group of drugs Xanax belongs to is VERY addictive.
    Oh. Also believe wholeheartedly that the drug will work and you can over come this. I know you can.

  22. paul43

    My doctor just switch me from Alprazolam to clonazepam— for me it is wayyyy better— last longer and no up & down feelings.

    • CARON
      owings mills, md 21117

      i agree with you.

  23. MW

    As a Board Certified R.N., licensed in 7 States, now disabled and retired I have taken Alprazolam for more than 5 years. It is extremely helpful to me both for anxiety and to help me get to sleep. I didn’t realize that I had an anxiety issue but did have moderate depression. My doc said she couldn’t give me any thing more for depression and so I asked “what about something for anxiety?”
    She prescribed Alprazolam and it has been just what I have needed for most of my life. I have no complications with it and find it helpful for a variety of life challenges. I could not recommend it more highly.

  24. lcf

    I only take Xanax occasionally to help me through difficult times (the death of my husband, cancer diagnosis and the like). I also was given the generic and instead of reducing my anxiety, I felt like crawling the walls. As someone else reported, a lot has to do with the manufacturer that the pharmacy used.
    I was surprised to learn that CVS uses a different manufacturer every 3 months, always shopping for the best price for their purchases, whereas Wal-Mart and Walgreens have consistently used the same manufacturer for years. The same held true with my script for Atenolol, which I have been taking for 10 years.
    I switched to CVS because of a promotion they had going and shortly thereafter developed 18 freckle/mole-like looking spots in my right arm pit. A biopsy showed that I was reacting to some med I was taking. My doctor told me to switch pharmacies but to call around to see who was buying from what company. That is when I learned what CVS was doing. I switched back to Wal-Mart and thank God, the spots disappeared after a few months. I also switched my Xanax script. The FDA in this country is a joke. You have to look out for yourself and ask a lot of questions!

  25. Paul43

    It never hurts to try a change to see if it works.

  26. SEH

    I have been taking generic Xanax for many years as needed, starting with the brand and later the generic. It is just recently that I have noticed that it is much less effective. I was glad go read the above article because I thought I was losing my mind. I have decided to transfer my Rx to a pharmacy that uses a different manufacturer to see if there is a difference.
    I believe there are some serious differences in the manufacture of generic meds. My insurance company also charges an astronomical amount for the brand Xanax. My prescription is from Walgreen and is make by Purepac. They say they have been using this manufacturer for some time but that they had just merged with another company. Maybe it was an error in the “batch” but it is extremely important that all processed meds meet exact quality standards.

  27. R.E.S.

    I experienced a severe depression early this year after discovering my only sister had Alzheimer’s disease.
    My doctor started me on the generic for Xanax, Alprazolam——starting with 0.25 mg, four times a day, and decreasing to 0.25mg twice a day in a matter of 10 days.
    I have been on alprazolam now for three months, AND I AM FEELING FINE. No problems at all.
    I plan on staying on the drug as long as I need (or longer) because I am now back to my old self——–all my activities——driving everywhere——able to laugh and have fun.

  28. kr

    You want to ask your pharmacy which manufacturer of alprazolam they use. Stay away from that manufacturer! Ask them to either get another manufacturer or switch to a pharmacy who dispenses from another manufacturer. It’s worth a try to use another brand, and might save a lot of money in the long run between costs of generic and brand-name. I think you would notice if the other manufacturer is or is not working for you right away…
    I did work at a pharmacy tech, and am on alprazolam also. Some other meds I had did not work in generic form until my pharmacy got in other manufacturers. I’ve been there!

  29. Joe M.

    When the Doctor prescribed alprozolam for me, I saw absolutely no change in my condition. After taking two refills, I quit instead of wasting my money. “Generics” is a good concept, if only it would work. Personally I truly believe the FDA and health insurer providers are co-conspirators in scam operation.

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